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General NPI Number Information
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NPI Number | 1396051629
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Entity Type | Organization
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Legal Business Name | FRIENDZ PHARMACY
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 13848 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48235-3926
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Country | US
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Telephone | 313-397-1103
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Fax | 313-397-1099
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Provider Business Mailing Address
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Address Line | 13848 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48235-3926
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Country | US
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Telephone | 313-397-1103
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Fax | 313-397-1099
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Authorized Official
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Title or Position | PHARMACIST/MGR
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Name | OLUGBADE BOLANLE
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Credential |
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Telephone | 734-218-4135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301009394
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License Number State | MI
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